JMIR Publications

ABSTRACT

Background:

The follow up of pediatric patients ensures regular ocular morbidity monitoring and better treatment outcome. Bharatpur Eye Hospital (BEH) noticed that the follow up rates were low among its pediatric patients. There are several factors including lack of awareness and forgetfulness among patients may contribute in less number of follow ups. Therefore, BEH decided to find if counselling and reminders through Short Message Service (SMS) and phone calls would improve the follow up rates.

Objective:

This study aims to evaluate the impact of interventions like counselling and reminder SMS and phone call in improving the follow up rate of pediatric patients.

Methods:

This is a public health intervention study, being conducted using the mixed method. Herein all children (0-16 years) with ocular conditions requiring at least 3 follow ups in the study period will be included. Two hundred and sixty four participants will be distributed to three groups: routine standard care, counseling and reminders with SMS and phone calls. In counseling, patients will take part in 20 minute counseling session with trained counselor in each visit and information leaflets will be provided to them. In reminder SMS and phone call group, patients will receive a SMS prior to 3 days and phone call one day prior to their scheduled visits. Patient attending within ± 2days of the scheduled date will be considered compliant to follow up. The proportion of patients completing all the follow ups in each group will be assessed. Informed consent will be taken from parent and child. Univariate and multivariate analysis will be conducted. The qualitative analysis about the barriers for follow up like educational status of the parent, distance and cost for travel will be done.

Results:

The ethical approval has been obtained from Ethical Review Board of Nepal Health Research Council (ERB protocol registration number 761/2020 P). The data collection was initiated from 24th of January 2021 but due to COVID-19 pandemic, as of June 2021, we have been able to enroll 112 participants (40% of the sample size).

Conclusions:

This study will reliably document not only the factors associated with follow up rate through intervention package (counseling and reminders through SMS and phone calls) but also cost effectiveness of the intervention package, which can be applied in all the departments of the hospital. Clinical Trial: The protocol has also been registered in ClinicalTrials.gov, (NCT04837534) on April 08, 2021